Path Analysis on the Biological and Social Economic Determinants of Neonatal Death in Bantul District, Yogyakarta

Abstract

Background: Nearly four million or two-thirds newborns (first week of life) worldwide die each year. Indonesia contributes 59% of infant death. Factors causing infant death are not only biological but also social economic. This study aimed to determine the biological and social economic factors of neonatal death in Bantul District, Yogyakarta. Subjects and Method: This was an analytic observational study with a case-control design. Population in this study was all neonates in Panembahan Senopati Hospital who birth from January 2017 to January 2018. A total sample of 200 neonates was selected for this study by fixed disease sampling, consisting of 50 dead and 150 alive neonates. The dependent variable was neonatal death. The independent variables were low birth-weight, asphyxia, prematurity, pregnancy infection, maternal age, maternal education, maternal employment status, and family income. The data were collected by questionnaire and analyzed by path analysis.Results: Risk of neonatal death increased with asphyxia (b=3,65; 95% CI= 1.77 to 5.52; p<0.001), prematurity (b=2.78; 95% CI= 1.64 to 3.92; p<0,001), and infection (b=3.04; 95% CI= 1.82 to 4.26; p<0.001). Asphyxia increased with low birthweight (b=1.42; 95% CI= 0.69 to 2.15; p<0.001), infection (b=1.62; 95% CI= 0.71 to 2.53; p=0.001), and decreased with maternal aged 20-35 years (b= -0.62; 95% CI= -1.37 to 0.13; p=0.108). Low birth weight increased with prematurity (b=4.28; 95% CI= 3.24 to 5.32; p<0.001) and decreased with family income (b=-1.22; 95% CI= -2.27 to -0.18; p=0.022). Infection decreased with higher maternal education (b= -0.57; 95% CI= -1.25 to 0.11; p=0.101). Family income increased with higher maternal education (b= 0.76; 95% CI= 0.04 to 1.48; p=0.038) and maternal work outside the house (b= 1.17; 95% CI= 0.32 to 2.02; p=0.007). Higher maternal education (b= 0.86; 95% CI= 0.26 to 1.47; p=0.005) increased the chance of mother working outside the house.Conclusion: The risk of neonatal death increased with asphyxia, prematurity, low birth weight, infection, maternal age <20 or ≥35 years, lower maternal education, maternal employment status, and family income.Keywords: neonatal death, risk factors, biologycal factor, social and economic factorCorrespondence: Funik Rahma Mei Listiani, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: funikrahmameilistiani@gmail.com. Journal of Maternal and Child Health (2018), 3(2): 91-99https://doi.org/10.26911/thejmch.2018.03.02.01